Clean Needles

THE NATIONAL Commission on AIDS has endorsed needle exchange programs among intravenous drug users in an effort to reduce the spread of the disease. It is a logical, common sense approach to the problem. The Bush administration, however, wants nothing to do with such programs. It thinks needle exchanges will only increase drug use by American citizens.One of the criticisms raised by the administration is that there is no scientific evidence showing that needle exchanges reduce risk-taking behavior.

The omnibus spending bill recently passed by Congress contained at least one piece of good news for Washington: A longtime restriction on using local funds for needle exchange programs was lifted. Removing the restriction was overdue because the district has one of the nation's highest rates of HIV/AIDS infection, and distributing clean needles to drug users could help slow the spread. Regrettably, a nationwide ban on using federal funds for needle exchange programs remains in place. Congress should follow its sensible action on D.C. and lift the national ban as well.

The traditional battles against AIDS and drug abuse came under scathing criticism this week when the National Commission on AIDS pointed out the obvious: Dealing with these twin scourges separately is myopic. The commission found that a full third of AIDS cases in this country stem from intravenous drug use -- either through sharing of infected needles or through sexual contact with an HIV-infected drug user.The commission recommended a practical approach -- expanded drug treatment programs linked with needle-exchange programs so that everyone who wants help can get it.Therein lies the controversy.

This article was reprinted with permission from Reader's Digest, where it first appeared. The author changed the names of some of the addicts to protect their privacy. PARKED NEXT to an abandoned lot on Baltimore's south side, the big cream-colored recreational vehicle seems out of place. So, too, do the dozen-odd men and women who gather by the RV's side door, most of them carrying brown-paper lunch sacks filled with used syringes. One or two at a time, they step inside and dump the needles onto a table.

The omnibus spending bill recently passed by Congress contained at least one piece of good news for Washington: A longtime restriction on using local funds for needle exchange programs was lifted. Removing the restriction was overdue because the district has one of the nation's highest rates of HIV/AIDS infection, and distributing clean needles to drug users could help slow the spread. Regrettably, a nationwide ban on using federal funds for needle exchange programs remains in place. Congress should follow its sensible action on D.C. and lift the national ban as well.

For the most part, when government mulls over the possibility of a needle-exchange program for controlling the spread of AIDS, the idea is almost immediately followed by the word "study," which has the effect of stopping any forward movement dead in its tracks.Although a steady stream of evidence now points to the conclusion that such programs do, in fact, reduce the transmission of the deadly HIV virus, a number of misperceptions still exist -- chief among them that giving addicts clean needles condones drug use, and that drug users deserve whatever happen to them as a consequence of their addiction.

WASHINGTON -- The federal government's first comprehensive study of whether giving clean needles to addicts can help prevent the spread of AIDS has concluded that it does and that the government should finance a significant expansion of such programs.The panel reviewed programs in the United States, Canada and Europe in which drug abusers can turn in a used needle and get a fresh, sterile one. The chief object of these programs is to end the drug abuser's need to share syringes that may have become contaminated with blood carrying the human immunodeficiency virus.

A divided Maryland Senate gave preliminary approval yesterday to a bill that would allow Prince George's, Montgomery and Baltimore counties to set up needle exchange programs.The proposal provoked a sharp election-year debate among lawmakers who called it tantamount to sanctioning drug abuse and others who argued that giving out clean needles reduces the spread of the deadly AIDS virus.The legislation was intended to allow such programs statewide, but 20 of the 23 counties withdrew through an amendment that split senators along ideological and regional lines.

Scientists at the Johns Hopkins School of Hygiene and Public Health believe they have found evidence that distributing sterile needles to drug addicts could help to stem the AIDS epidemic.A study in Baltimore of people who inject illegal drugs has found that addicts who happen to have diabetes are less than half as likely to contract the AIDS virus than are addicts who don't have the disease.Dr. Kenrad Nelson, an epidemiologist, said that there is only one likely explanation for the difference: Diabetes enables addicts to buy clean needles at any pharmacy, making it less probable that they will share dirty needles when injecting heroin or cocaine.

Distributing clean needles to addicts has not contributed to drug-related crime or to the number of discarded syringes in streets and alleys, according to a study of Baltimore's needle-exchange program.Researchers at the Johns Hopkins School of Public Health said arrest patterns were not significantly different in areas served by the program than in other areas of the city. This held true for cocaine and heroin possession as well as burglaries, prostitution and other crimes linked to drug activity.

Distributing clean needles to addicts has not contributed to drug-related crime or to the number of discarded syringes in streets and alleys, according to a study of Baltimore's needle-exchange program.Researchers at the Johns Hopkins School of Public Health said arrest patterns were not significantly different in areas served by the program than in other areas of the city. This held true for cocaine and heroin possession as well as burglaries, prostitution and other crimes linked to drug activity.

A divided Maryland Senate gave preliminary approval yesterday to a bill that would allow Prince George's, Montgomery and Baltimore counties to set up needle exchange programs.The proposal provoked a sharp election-year debate among lawmakers who called it tantamount to sanctioning drug abuse and others who argued that giving out clean needles reduces the spread of the deadly AIDS virus.The legislation was intended to allow such programs statewide, but 20 of the 23 counties withdrew through an amendment that split senators along ideological and regional lines.

THERE'S A strong case to be made against needle exchange programs in which intravenous drug users can exchange a used needle for a clean one. After all, government has a clear interest in promoting lawful behavior, and an equally strong interest in not making such behavior easier or safer to indulge in. But in the case of needle exchange programs, the dangers of not providing addicts with clean needles are too overwhelming to ignore.Now, with three years of experience, city officials have the evidence to back up their case that a carefully controlled needle exchange program can dramatically slow the rate of HIV infection, while also giving addicts a chance to enter treatment.

They call it suicide on a payment plan.After only a few hours' sleep, they wake up with achy joints, sweats and chills. Immediately, they need drugs to feel stable. So they hit the streets for their equivalent of the workday -- an eight- or sometimes 10- to 12-hour shift of begging, shoplifting or robbing."All day, you're in and out of stores, stealing, then running back and forth to the drug man," said Pam Day, a West Baltimore woman who is fighting her heroin and cocaine addictions. "At the end of the day, your arm is sore, your vein is almost collapsed.

In the chilly wind and spitting rain, a dozen people lined up alongside the Winnebago, quietly waiting their turn. One by one, they climbed into the warm van, nodding hello.Then they got down to business.Reaching deep in their pockets, plastic bags and even a child's lunch box decorated with cartoon characters, they pulled out handfuls of syringes -- needles they had used to inject themselves with heroin and cocaine. Some had five or six, others as many as 80.This is the Baltimore City Health Department's Needle Exchange Program.

WASHINGTON -- The federal government's first comprehensive study of whether giving clean needles to addicts can help prevent the spread of AIDS has concluded that it does and that the government should finance a significant expansion of such programs.The panel reviewed programs in the United States, Canada and Europe in which drug abusers can turn in a used needle and get a fresh, sterile one. The chief object of these programs is to end the drug abuser's need to share syringes that may have become contaminated with blood carrying the human immunodeficiency virus.

THERE'S A strong case to be made against needle exchange programs in which intravenous drug users can exchange a used needle for a clean one. After all, government has a clear interest in promoting lawful behavior, and an equally strong interest in not making such behavior easier or safer to indulge in. But in the case of needle exchange programs, the dangers of not providing addicts with clean needles are too overwhelming to ignore.Now, with three years of experience, city officials have the evidence to back up their case that a carefully controlled needle exchange program can dramatically slow the rate of HIV infection, while also giving addicts a chance to enter treatment.

Legislation to create a needle-exchange pilot program in Baltimore as a way to prevent the spread of AIDS among intravenous drug users was narrowly rejected yesterday by a state House panel.The House Judiciary Committee voted 13 to 11 against the proposal, which Mayor Kurt L. Schmoke and other supporters modeled after successful programs in U.S. and European cities.Most committee members said they were uncomfortable with the idea of allowing intravenous drug users to turn in dirty hypodermic syringes in exchange for clean ones.

Seeking to attack a major source of transmission for the AID virus, Baltimore Mayor Kurt L. Schmoke said last night that the city will again ask the General Assembly for an exemption in drug laws to allow a clean- needle exchange program for addicts.Speaking at the 5th annual Baltimore City-Baltimore County AIDS conference, Mr. Schmoke said drug-paraphernalia laws would have to be changed before the city could have a needle exchange -- which he has long advocated.A similar proposal died in the 1992 legislative session.